Angiopoietin-like protein 5: a potential culprit of cardio-metabolic risk in Egyptian obese children

Background Obesity has recently been identified as a risk factor for coronavirus disease-19. There is a significant correlation between obesity rates with metabolic syndrome and coronavirus disease-19 in children worldwide. Owing to the high expression in adipose tissue, angiopoietin-like protein 5 (ANGPTL5) might be assumed to have a broad range of physiological processes in lipid, glucose homeostasis, and inflammatory responses. Objective To examine the association between childhood obesity and plasma ANGPTL5 levels in an attempt to demonstrate the probable relationships of plasma levels of ANGPTL5 with unacylated ghrelin and obestatin and its relevance to metabolic parameters in obese versus normal-weight children and adolescents. Patients and methods A total of 90 children between 5 and 15 years of age were randomly enrolled in this cross-sectional case–control study. They were classified into obese patients (n=45) and nonobese controls (n=45). BMI for age was calculated following WHO guidelines. Serum levels of ANGPTL5, obestatin, and unacylated ghrelin were measured and correlated with the anthropometric measurements and biochemical markers of metabolic syndrome. Results A highly significant positive correlation was observed between the serum level of ANGPTL5 and the weight z score. Moreover, a significant positive correlation between ANGPTL5 and the investigated diabetic parameters (glucose, insulin, and homeostasis model assessment for insulin resistance) and high sensitivity C-reactive protein was detected. The increased weight in children was associated with a higher level of ANGPTL5 in parallel with the observed elevated insulin resistance. Conclusion ANGPTL5 might be considered a promising sensitive assessment biomarker to be applied for early diagnosis and prognosis of obese children with a high risk of cardio-metabolic diseases.